Understanding Ketosis and the Ketogenic Diet
The ketogenic diet has grown enormously in popularity over the last few years. This very low-carb, high fat diet shifts the body's metabolism into a state known as ketosis. When followed correctly, ketosis has been associated with benefits like accelerated fat loss, reduced hunger levels, improved mental focus and performance, and more stable energy levels.
Ketosis occurs when carbohydrate restriction causes the body to rely largely on fat for fuel. Specifically, the liver begins converting fat into fatty acid-derived compounds called ketone bodies. The three main ketone bodies acetone, acetoacetate, and beta-hydroxybutyrate (BHB) can provide energy for the cells. Their levels rise significantly in the bloodstream during ketosis.
Getting into robust ketosis by severely restricting carb intake often takes 3-5 days. This transition is sometimes accompanied by unpleasant symptoms collectively known as the keto flu. Symptoms like fatigue, brain fog, irritability, and headaches stem from the body having to adapt to using ketones and fat for energy instead of its preferred source of carbs.
Speeding Up Ketosis with Exogenous BHB Ketones
An alternative approach to getting into ketosis faster is by ingesting ketones in supplement form. Supplements providing beta-hydroxybutyrate (BHB) ketones are known as exogenous ketones, as the ketones come from outside the body rather than being produced internally.
BHB is used because, unlike the other two main ketones, it can readily cross the blood-brain barrier to provide the brain with energy. As such, BHB supplements promise a quicker transition into the coveted metabolic state of ketosis. Less keto flu symptoms may also be expected.
But are the purported benefits of faster, smoother, and deeper ketosis true when using exogenous BHB ketones? And are there any potential risks involved?
Mechanisms and Evidence on Exogenous BHB Ketones
BHB ketone salts and BHB ketone esters are the two main forms of supplements that provide the body with a direct beta-hydroxybutyrate source.
These exogenous BHB ketone sources work via a few key mechanisms:
- They significantly elevate blood ketone levels.
- This signals the body it can conserve glucose and glycogen stores.
- Endogenous ketone production may also ramp up in response.
In short, supplemental ketones put the body into a state of pseudo- or biochemical ketosis. The boost in ketone body levels mimics what occurs on a very low carb ketogenic diet.
But despite the clear increase in circulating blood ketones, the benefits beyond that are still being actively researched. The evidence is very limited in humans at this point, with most research having been done on animals.
Exogenous Ketones and Weight Loss
Several rodent studies have found promising weight loss or body composition effects from either BHB salts or ketone esters. But further study is needed to see if this carries over to humans looking to lose weight with the ketogenic diet or other low carb diets.
There does appear to be a link between higher blood ketone levels and increased weight loss. However, more research is still needed on BHB supplements specifically.
Effects on Mental and Physical Performance
Due to the brain's ability to use ketone bodies for fuel, much interest lies in whether exogenous ketones can boost mental performance.
For this goal, ketone esters seem to show more reliable effects than BHB salts in the limited research to date. Further study on focus, memory, cognition, and related areas is still needed.
In terms of physical performance and athletic ability, the potential benefits of supplemental BHB are promising but inconclusive. Ketone esters, however, may have more consistent ergogenic and anti-fatigue effects during exercise.
Other Possible Benefits
Animal research hints that exogenous ketones may mimic some of the other unique benefits associated with nutritional ketosis. These potential effects include:
- Reduced seizures
- Decreased anxiety and depression
- Lowered blood sugar levels
- Protection against brain injury
- Anti-inflammatory effects
But again, human data is severely lacking at this time. So any applications to these human health conditions are strictly speculative.
Is There Any Downside to Exogenous Ketone Use?
Despite the tantalizing possibilities of BHB ketone supplements, some cautions should be kept in mind as well. Most stem from the simple fact that these supplements have just not been studied thoroughly.
Potential concerns include:
- Gastrointestinal distress BHB salts are often reported to cause temporary nausea, diarrhea, and stomach upset when initially used until tolerance builds.
- Ketoacidosis This pathological state of severe blood acidity is seen in uncontrolled diabetes. Though very unlikely, artificially elevated ketones could theoretically induce a dangerous drop in blood pH.
- Altered lipid profiles Animal studies suggest exogenous ketones can raise cholesterol and triglycerides in some instances. But the extent to which this occurs in humans is unknown.
- Changes in electrolyte balance Rapid shifts in hydration, minerals, and electrolytes seem possible with sudden ketosis induction.
- Unknown long-term effects The prolonged effects of consistently ingesting exogenous BHB sources have not been studied.
Additionally, these supplements tend to be expensive, with dubious marketing claims being made by some ketone product manufacturers.
Who Should Not Use Exogenous Ketone Supplements?
Until more extensive safety data is available, certain groups should exercise greater caution or avoid exogenous ketones altogether. These include:
- Pregnant or breastfeeding women.
- Children under 18 years old.
- People with uncontrolled diabetes.
- Those with renal impairment or kidney disease.
- Individuals with active gallbladder issues.
- Anyone with a history of ketoacidosis or abnormal lipid profiles.
Consult a doctor before trying ketone supplements if you have any medical conditions or take prescription medications.
Choosing the Best Exogenous Ketone Supplement
As the science continues to emerge, some key factors to keep in mind when comparing BHB ketone products include:
- Type Salts or esters both effectively raise ketone levels, but may have differing effects otherwise.
- BHB dosage Products range from about 3 grams per serving up to 25 grams or more.
- Minerals Salts supply supplemental minerals that affect tolerability.
- Ingredients Some products add MCT powder, caffeine, amino acids, etc.
- Safety record Company transparency and processing methods matter.
- Cost Ketone supplements are expensive, so price varies widely.
- Flavors Palatability ranges from unpleasantly salty to tolerably fruity.
It also must be considered that some individuals seem to respond better than others to supplemental ketones for reasons not yet fully understood.
Experimenting with different BHB products while closely monitoring effects may be necessary to see if you are an exogenous ketone responder. And cycling ketone supplements with time off is advisable to check for continued benefits over time.
The Bottom Line: A Helpful Hack for Some
In summary, early research is encouraging that exogenous ketone supplements may accelerate the transition into ketosis. They likely mimic certain aspects of nutritional ketosis via rising blood BHB levels. But just how substantial this hack is for most people still requires further study.
Supplemental BHB also allows for occasional one-off use with carb-heavy meals. This may counter a glucose spike and make reentering ketosis faster afterwards.
Still, exogenous ketones should be seen as a supportive aid primarily. They cannot replace the initial hard work of significantly cutting carbs to drive the metabolic shift. Nor should they keep you from making progress on developing lasting dietary changes for better health.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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